1. Treatment of Essential Tremor with Stereotactic Radiosurgery
Presenter: Christopher Loiselle, MD
Poster # 1024

2. Treatment of Essential Tremor with Stereotactic Radiosurgery
Very common (5% population > age 65)
Primarily an action tremor
95% of the time affects hands
Can be disabling leading to basic activities such as writing, drinking, eating, cooking, using utensils, brushing teeth, holding a tray.
Familial in 60%
Pathophysiologic recordings of VIM thalamus demonstrate neurons that dischage excessively and synchronously

3. Treatment of Essential Tremor with Stereotactic Radiosurgery
Treatment options: medical therapy, deep brain stimulation, radiosurgical thalamotomy
Radiosurgical thalamotomy is an ideal treatment for patients with medically refractory disease who are not candidates for deep brain stimulation

4. Treatment of Essential Tremor with Stereotactic Radiosurgery
Current retrospective series:
99 thalamotomies with the Gamma Knife in 94 patients
77% of cases had major improvement in drawing
81% of cases had major improvement in writing
7 patients developed side effects following treatment including contralateral numbness, contralateral weakness, or speech difficulty. One patient’s side effects resolved during the followup period.

5. Treatment of Essential Tremor with Stereotactic Radiosurgery
For patients with a positive result (about 80%), the benefits of treatment are a remarkable improvement in life quality
The future:
Prospective studies
Development of patient selection tools and/or treatment techniques to further minimize potential side effects.